Necesidades insatisfechas de planificación familiar y factores relacionados en hombres de cinco países de Latinoamérica

Objetivos: Estimar la necesidad insatisfecha de planificación familiar con métodos modernos identificando factores relacionados en hombres de Colombia, Guatemala, Haití, Honduras y Panamá. Métodos: Este estudio transversal utilizó datos de encuestas representativas a nivel nacional en Colombia, Guatemala, Haití, Honduras y Panamá para analizar entrevistados casados/unidos de 15-59 años con necesidades de planificación familiar. La relación de factores con la necesidad insatisfecha se probó mediante regresión logística multivariable. Resultados: La necesidad insatisfecha era mayor en Haití (46.5%), seguido por Panamá (43.0%), Guatemala (36.8%), Honduras (21.3%) y Colombia (12.4%). Las oportunidades relativas ajustadas de necesidad insatisfecha aumentaron con la edad en todos los países; eran mayores en pertenecientes a pueblos indígenas de Colombia, Guatemala, Honduras y Panamá; en quienes vivían en hogares con menor bienestar en Guatemala, Honduras y Panamá; y en quienes informaron uniones formales en Guatemala y Honduras. Las oportunidades de necesidad insatisfecha disminuyeron con mayor escolaridad en Haití; con mayor conocimiento de métodos modernos en Guatemala y Honduras; si discutieron sobre planificación familiar con algún profesional/trabajador de salud en Haití y Panamá; y si recibieron información sobre planificación familiar en medios de comunicación en Colombia. Conclusiones: Existen factores demográficos, socioeconómicos, de acceso a información y comportamiento relacionados con la necesidad insatisfecha. Incluir a los hombres en los programas de planificación familiar y en el desarrollo de intervenciones culturalmente aceptadas contribuiría a acelerar el logro del ejercicio responsable y voluntario del derecho a decidir si reproducirse, cuándo y con qué frecuencia. (provisto por Infomedic International)

Objectives: To estimate unmet need for family planning with modern methods, identifying related factors, in men from Colombia, Guatemala, Haiti, Honduras, and Panama. Methods: This cross-sectional study used data from nationally representative surveys in Colombia, Guatemala, Haiti, Honduras, and Panama to analyze 15-59 years old married or cohabiting men in need of family planning. The relationship of factors with unmet need was tested using multivariate logistic regression. Results: The unsatisfied need was higher in Haiti (46.5%), followed by Panama (43.0%), Guatemala (36.8%), Honduras (21.3%), and Colombia (12.4%). The adjusted odds ratio for unmet need increased with age in all countries and were greater in men from indigenous people of Colombia, Guatemala, Honduras, and Panama; in those who were living in households with less well-being in Guatemala, Honduras, and Panama; and in those who reported formal cohabiting in Guatemala and Honduras. The adjusted odds ratio for unsatisfied need diminished with increasing education in Haiti; with greater knowledge of modern methods in Guatemala and Honduras; if they discussed family planning with a health professional or worker in Haiti and Panama; and if they received information on family planning in the media in Colombia. Conclusions: There are demographic, socioeconomic, access to information, and behavioral factors related to unsatisfied need. Including men in family planning programs and in the development of culturally accepted interventions would help accelerate the achievement of the responsible and voluntary exercise of the right to decide whether, when, and how often to reproduce. (provided by Infomedic International)

The contribution of global aviation to anthropogenic climate forcing for 2000 to 2018.

Global aviation operations contribute to anthropogenic climate change via a complex set of processes that lead to a net surface warming. Of importance are aviation emissions of carbon dioxide (CO2), nitrogen oxides (NOx), water vapor, soot and sulfate aerosols, and increased cloudiness due to contrail formation. Aviation grew strongly over the past decades (1960-2018) in terms of activity, with revenue passenger kilometers increasing from 109 to 8269 billion km yr-1, and in terms of climate change impacts, with CO2 emissions increasing by a factor of 6.8 to 1034 Tg CO2 yr-1. Over the period 2013-2018, the growth rates in both terms show a marked increase. Here, we present a new comprehensive and quantitative approach for evaluating aviation climate forcing terms. Both radiative forcing (RF) and effective radiative forcing (ERF) terms and their sums are calculated for the years 2000-2018. Contrail cirrus, consisting of linear contrails and the cirrus cloudiness arising from them, yields the largest positive net (warming) ERF term followed by CO2 and NOx emissions. The formation and emission of sulfate aerosol yields a negative (cooling) term. The mean contrail cirrus ERF/RF ratio of 0.42 indicates that contrail cirrus is less effective in surface warming than other terms. For 2018 the net aviation ERF is +100.9 milliwatts (mW) m-2 (5-95% likelihood range of (55, 145)) with major contributions from contrail cirrus (57.4 mW m-2), CO2 (34.3 mW m-2), and NOx (17.5 mW m-2). Non-CO2 terms sum to yield a net positive (warming) ERF that accounts for more than half (66%) of the aviation net ERF in 2018. Using normalization to aviation fuel use, the contribution of global aviation in 2011 was calculated to be 3.5 (4.0, 3.4) % of the net anthropogenic ERF of 2290 (1130, 3330) mW m-2. Uncertainty distributions (5%, 95%) show that non-CO2 forcing terms contribute about 8 times more than CO2 to the uncertainty in the aviation net ERF in 2018. The best estimates of the ERFs from aviation aerosol-cloud interactions for soot and sulfate remain undetermined. CO2-warming-equivalent emissions based on global warming potentials (GWP* method) indicate that aviation emissions are currently warming the climate at approximately three times the rate of that associated with aviation CO2 emissions alone. CO2 and NOx aviation emissions and cloud effects remain a continued focus of anthropogenic climate change research and policy discussions.

Electric radiation mapping of silver/zinc oxide nanoantennas by using electron holography.

In this work, we report the fabrication of self-assembled zinc oxide nanorods grown on pentagonal faces of silver nanowires by using microwaves irradiation. The nanostructures resemble a hierarchal nanoantenna and were used to study the far and near field electrical metal-semiconductor behavior from the electrical radiation pattern resulting from the phase map reconstruction obtained using off-axis electron holography. As a comparison, we use electric numerical approximations methods for a finite number of ZnO nanorods on the Ag nanowires and show that the electric radiation intensities maps match closely the experimental results obtained with electron holography. The time evolution of the radiation pattern as generated from the nanostructure was recorded under in-situ radio frequency signal stimulation, in which the generated electrical source amplitude and frequency were varied from 0 to 5 V and from 1 to 10 MHz, respectively. The phase maps obtained from electron holography show the change in the distribution of the electric radiation pattern for individual nanoantennas. The mapping of this electrical behavior is of the utmost importance to gain a complete understanding for the metal-semiconductor (Ag/ZnO) heterojunction that will help to show the mechanism through which these receiving/transmitting structures behave at nanoscale level.

Treadmill training stimulates brain-derived neurotrophic factor mRNA expression in motor neurons of the lumbar spinal cord in spinally transected rats.

Brain-derived neurotrophic factor (BDNF) induces plasticity within the lumbar spinal circuits thereby improving locomotor recovery in spinal cord-injured animals. We examined whether lumbar spinal cord motor neurons and other ventral horn cells of spinally transected (ST) rats were stimulated to produce BDNF mRNA in response to treadmill training. Rats received complete spinal cord transections as neonates (n=20) and one month later, received four weeks of either a low (100 steps/training session; n=10) or high (1000 steps/training session; n=10) amount of robotic-assisted treadmill training. Using combined non-radioactive in situ hybridization and immunohistochemical techniques, we found BDNF mRNA expression in heat shock protein 27-labeled motor neurons and in non-motor neuron cells was greater after 1000 steps/training session compared to the 100 steps/training session and was similar to BDNF mRNA labeling in untrained Intact rats. In addition, there were significantly more motor neurons that contained BDNF mRNA labeling within processes in the ST rats that received the higher amount of treadmill training. These findings suggested that motor neurons and other ventral horn cells in ST rats synthesized BDNF in response to treadmill training. The findings support a mechanism by which postsynaptic release of BDNF from motor neurons contributed to synaptic plasticity.

Neuromodulation of the posterolateral hypothalamus for the treatment of chronic refractory cluster headache: Experience in five patients with a modified anatomical target.

INTRODUCTION: Deep brain stimulation (DBS) of the posterior hypothalamus has been found to be effective in the treatment of refractory chronic cluster headache (CCH). METHODS: We report the long-term outcomes of five patients with refractory CCH on whom stimulation of a modified target of approximately 3 mm in radius, which included the posterolateral hypothalamus, the fasciculus mammillotegmentalis, the fasciculus mammillothalamicus and the fasciculus medialis telencephali, was performed. The stereotaxic coordinates were 4 mm from the third ventricle wall, 2 mm from behind the mid-intercommissural point and 5 mm from under the intercommissural line. RESULTS: All patients became pain-free for 1-2 weeks after the procedure, but then needed an average of 54 days to optimize stimulation parameters. After a mean follow-up of 33 months, two remain pain-free, two have an excellent response (>90% decrease in attack frequency) and in one the attacks have been reduced by half. There were no serious adverse events. Permanent myosis and euphoria/well-being feeling were seen in three patients. Other adverse events, such as diplopia, dizziness, global headache of cervical dystonia, were seen transiently related to an increase in stimulation parameters. Attacks reappeared transiently in two patients as a result of cable rupture and when the stimulator was disconnected. CONCLUSIONS: Our results supports the efficacy of DBS in very refractory CCH with a slightly modified hypothalamic target conceived to avoid the lateral ventricle wall so as to extend the stimulated brain area and to decrease the morbidity of potential haemorrhagic complications.

Survival of adenovirus types 2 and 41 in surface and ground waters measured by a plaque assay.

To manage artificial recharge systems, it is necessary to understand the inactivation process of microorganisms within aquifers so that requirements regarding storage times and treatment strategies for ground and surface waters can be developed and modeled to improve water management practices. This study was designed to investigate the survival of representative adenoviruses in surface- and groundwaters using a cell culture plaque assay with human lung carcinoma cells (A549) to enumerate surviving viruses. Adenovirus types 2 (Ad2) and 41 (Ad41) were seeded into 50 mL of three sterilized surface waters and groundwaters, and incubated at 10 and 19 °C for up to 301 days. Concentrations of Ad2 and Ad41 were relatively stable in all waters at 10 °C for at least 160 days and in some instances up to 301 days. At 19 °C, virus concentrations were reduced by 99.99% (4 log) after 301 days in surface water. There was approximately 90% (1 log) reduction of both viruses at 19 °C after 160 days of incubation in groundwater samples. There was no overall difference in survival kinetics in surface waters compared to groundwaters. The relatively high stability and long-term survival of adenoviruses in environmental waters at elevated temperatures should be considered in risk assessment models and drinking water management strategies.

Effect of functional electrical stimulation (FES) combined with robotically assisted treadmill training on the EMG profile.

Functional electrical stimulation (FES) is used to assist spinal cord injury patients during walking. However, FES has yet to be shown to have lasting effects on the underlying neurophysiology which lead to long-term rehabilitation. A new approach to FES has been developed by which stimulation is timed to robotically controlled movements in an attempt to promote long-term rehabilitation of walking. This approach was tested in a rodent model of spinal cord injury. Rats who received this FES therapy during a 2-week training period exhibited peak EMG activity during the appropriate phase of the gait cycle; whereas, rats who received stimulation which was randomly timed with respect to their motor activity exhibited no clear pattern in their EMG profile. These results from our newly developed FES system serve as a launching point for many future studies to test and understand the long-term effect of FES on spinal cord rehabilitation.

Functional recovery of stepping in rats after a complete neonatal spinal cord transection is not due to regrowth across the lesion site.

Rats receiving a complete spinal cord transection (ST) at a neonatal stage spontaneously can recover significant stepping ability, whereas minimal recovery is attained in rats transected as adults. In addition, neonatally spinal cord transected rats trained to step more readily improve their locomotor ability. We hypothesized that recovery of stepping in rats receiving a complete spinal cord transection at postnatal day 5 (P5) is attributable to changes in the lumbosacral neural circuitry and not to regeneration of axons across the lesion. As expected, stepping performance measured by several kinematics parameters was significantly better in ST (at P5) trained (treadmill stepping for 8 weeks) than age-matched non-trained spinal rats. Anterograde tracing with biotinylated dextran amine showed an absence of labeling of corticospinal or rubrospinal tract axons below the transection. Retrograde tracing with Fast Blue from the spinal cord below the transection showed no labeled neurons in the somatosensory motor cortex of the hindlimb area, red nucleus, spinal vestibular nucleus, and medullary reticular nucleus. Retrograde labeling transsynaptically via injection of pseudorabies virus (Bartha) into the soleus and tibialis anterior muscles showed no labeling in the same brain nuclei. Furthermore, re-transection of the spinal cord at or rostral to the original transection did not affect stepping ability. Combined, these results clearly indicate that there was no regeneration across the lesion after a complete spinal cord transection in neonatal rats and suggest that this is an important model to understand the higher level of locomotor recovery in rats attributable to lumbosacral mechanisms after receiving a complete ST at a neonatal compared to an adult stage.

Sistema informático perinatal (SIP): historia clínica perinatal: formulario complementario para mujeres en situación de aborto: instrucciones de llenado y definición de términos

En este manual se describe en detalle la forma de llenado y la definición e interpretación de cada una de las variables que presenta la Historia Clínica Perinatal y del sector correspondiente a Mujeres en Situación de Aborto. La Historia Clínica deberá facilitar la atención, el monitoreo y la supervisión del cumplimiento de las normas, de tal manera que el sistema de salud cuente con información precisa y oportuna para la toma de decisiones. La riqueza de datos contenidos en la Historia Clínica Perinatal y sus formularios complementarios permiten constituir el banco de datos más valioso con que cuenta el equipo de salud, ya sea para conocer las características de la población prestataria, evaluar los resultados de la atención brindada, identificar los problemas prioritarios, monitorizar indicadores claves y realizar investigaciones operacionales y epidemiológicas.

Digoxin and digoxin-like immunoreactive factors (DLIF) modulate the release of pro-inflammatory cytokines.

OBJECTIVE: Cardiac glycosides such as digoxin and their endogenous counterpart digoxin-like immunoreactive factor (DLIF) may possess anti-inflammatory properties. METHODS: Pro-inflammatory cytokines from human peripheral blood mononuclear cells (PBMC) were measured by ELISA using specific antibodies. Immunocytochemistry was used to localize NF-K: B. RESULTS: Non-stimulated PBMC constitutively secreted minimum amounts of cytokines. LPS (1 mg/L) stimulation lead to steep increases in TNF-alpha, IL-6 and IL-8 concentrations with peak rises at 8 h. An 8 h delay was observed for IL-10. Increases in IL-10 were sustained for18 h period. Significant inhibition (P > 0.05) of TNF-alpha, IL-6 and IL-8 at non-toxic of digoxin concentration (< 100 nM) and DLIF (10 nM digoxin equivalent (de)) was observed whereas no such effect was seen for IL-10. Inhibition of the degradation of activated NF-K: B in the PBMC was observed with the indicated concentrations of digoxin, DLIF or Pyrrolidine dithiocarbamate (PDTC). CONCLUSION: Digoxin and DLIF inhibit the release of proinflammatory cytokines from PBMC via NF-K: B-dependent pathway suggesting an anti-inflammatory effect.

Hemangioblastoma quístico de bulbo raquídeo / Cystic bulbar hemangioblastoma

Introducción. Los hemangioblastomas son neoplasias de naturaleza vascular y de características benignas. Representan entre el 2 y el 3% de los tumores cerebrales, y entre el 7 y el 12% de los procesos neoformativos localizados en la fosa posterior. La primera descripción de esta enfermedad se remonta al año 1904, cuando von Hippel hizo pública la primera descripción del hemangioma retiniano. Caso clínico. Varón de 41 años que acudió a su médico, tras presentar durante tres semanas episodios intermitentes de hipo, autolimitados y de duración variable, en ocasiones relacionados con la ingesta y en otras aparecían de forma espontánea. En la exploración neurológica llamaba la atención la presencia de hipoestesia toracoabdominal izquierda. Mediante técnicas de neuroimagen se diagnosticó una lesión tumoral, bien delimitada, quística, de localización bulbar. El abordaje quirúrgico se realizó mediante craniectomía suboccipital, y se llevó a cabo una extirpación completa de la lesión. El estudio anatomopatológico confirmó el diagnóstico de hemangioblastoma. El paciente evolucionó satisfactoriamente, sin presentar nueva clínica neurológica. Conclusión. La localización más frecuente de los hemangioblastomas es en el vérmix y los hemisferios cerebelosos, siendo infrecuente la localización bulbar, que representa un porcentaje inferior al 5% de los hemangioblastomas cerebrales, así como la forma de presentación clínica mediante hipo persistente

Introduction. Hemangioblastomas are neoplasm of vascular type having benign characteristics. They representbetween 2-3% of brain tumors and 7-12% of neoformative processes in the posterior fossa. The first description of the disease goes back to the year 1904, when Eugene von Hippel made the description of retinal haemangioblastoma. Case report. A male patient of 41 years-old who went to his doctor after three weeks of having intermittent episodes of hiccups. In the neurological examination the presence of left thoracic-abdominal hypoesthesia was shown. Brain tumor was diagnosed by neuroimagetechniques. It was well defined, cystic and placed in bulbar region. Surgical approach was carried out by means of suboccipital craniectomy, with the complete removal of the lesion. The histological study confirmed the hemangioblastoma diagnosis. The patient evolved satisfactory, without presenting new neurological symptoms. Conclusion. The most frecuent localization of hemangioblastomas is in vermix and cerebellum hemispheres. The bulbar localization is infrequent (whichrepresents less percentage than 5% of cerebral hemangioblastomas) likewise the clinical manifestation though hiccups

[Cystic bulbar hemangioblastoma]. / Hemangioblastoma quístico de bulbo raquídeo.

INTRODUCTION: Hemangioblastomas are neoplasm of vascular type having benign characteristics. They represent between 2-3% of brain tumors and 7-12% of neoformative processes in the posterior fossa. The first description of the disease goes back to the year 1904, when Eugene von Hippel made the description of retinal haemangioblastoma. CASE REPORT: A male patient of 41 years-old who went to his doctor after three weeks of having intermittent episodes of hiccups. In the neurological examination the presence of left thoracic-abdominal hypoesthesia was shown. Brain tumor was diagnosed by neuroimage techniques. It was well defined, cystic and placed in bulbar region. Surgical approach was carried out by means of suboccipital craniectomy, with the complete removal of the lesion. The histological study confirmed the hemangioblastoma diagnosis. The patient evolved satisfactory, without presenting new neurological symptoms. CONCLUSION: The most frecuent localization of hemangioblastomas is in vermix and cerebellum hemispheres. The bulbar localization is infrequent (which represents less percentage than 5% of cerebral hemangioblastomas) likewise the clinical manifestation though hiccups.

Misoprostol for the termination of pregnancy with a live fetus at 13 to 26 weeks.

A combination of mifepristone and misoprostol is the regimen of choice for termination of pregnancy between 13 to 26 weeks. In many countries, mifepristone is still not available, and misoprostol has to be used alone. Many misoprostol-alone regimens have been reported in the literature with apparently good results. Most of the trials were conducted in pregnancies between 13 and 22 weeks. For this gestational period, we recommend the regimen of 400 microg of vaginal misoprostol every 3 h up to 5 doses, as it appears to be effective without excessive side effects or complications. There is inadequate data to recommend a regimen for the gestational period of 23 to 26 weeks but it is advisable to reduce the dose and frequency of administration of misoprostol. Common side effects of misoprostol-induced termination of pregnancy include gastrointestinal side effects, abdominal cramps, bleeding, fever and chills. Complications may include infection or rarely rupture of uterus.

Misoprostol to treat missed abortion in the first trimester.

Missed abortion in the first trimester is characterized by the arrest of embryonic or fetal development. The cervix is closed and there is no or only slight bleeding. Ultrasound examination shows an empty gestational sac or an embryo/fetus without cardiac activity. Based on a review of the published literature a single dose of 800 microg vaginal misoprostol may be offered as an effective, safe, and acceptable alternative to the traditional surgical treatment for this indication. Alternatively, 600 microg misoprostol can be administered sublingually. After administration of misoprostol, hospitalization is not necessary and the time to expulsion varies considerably. Bleeding may last for more than 14 days with additional days of light bleeding or spotting. The woman should be advised to contact a provider in case of heavy bleeding or signs of infection. A follow-up is recommended after 1 to 2 weeks.

Misoprostol for intrauterine fetal death.

The frequency of intrauterine fetal death (IUFD) with retained fetus varies, but is estimated to occur in 1% of all pregnancies. The vast majority of women will spontaneously labor and deliver within three weeks of the intrauterine death. The complexity in medical management increases significantly when the cervix is unripe or unfavorable, or when the woman develops disseminated intravascular coagulation. Misoprostol regimens for the induction of labor for second and third trimester IUFDs, range from 50 to 400 microg every 3 to 12 h, and are all clinically effective. Nevertheless, the current scientific evidence supports vaginal misoprostol dosages, which are adjusted to gestational age: between 13-17 weeks, 200 microg 6-hourly; between 18-26 weeks, 100 microg 6-hourly; and more than 27 weeks, 25-50 microg 4-hourly. In women with a previous cesarean, lower doses should be used and doubling of doses should not occur. Clinical monitoring should continue after delivery or expulsion because of the risk of postpartum atony and/or placenta retention.

Infecciones de transmisión sexual, mas comunes adolescentes panameñas / Infections of sexual transmission, but common adolescents Panamanian

Informa que anualmente, a nivel mundial existen más de 300 millones de nuevos casos de Infección de Transmisión Sexual, sin tomar en cuenta al VIH- SIDA, y de estas 100 millones corresponden a jóvenes de 15 a 24 años de edad (1) (2). Afecta a cualquier población como niños, adolescentes, adultos etc., no tiene edad, posición social ni credo. El objetivo principal de este estudio era el de identificar las infecciones de Transmisión Sexual más comunes en un grupo de Adolescentes Panameñas que acudían a la clínica de planificación familiar del Centro de Investigación Humana (CIRH).Se captaron un total de 150 jóvenes, que acudían por atención a la clínica del adolescente del Centro de Investigación en Reproducción Humana del ( CIRH )de Panamá, durante un período de 6meses del año 2002. A todas se les tomaron muestras de sangre para realizar las pruebas de Clamidia, Herpes tipo2, Hepatitis B, Sífilis y el VIH. De igual forma se les extrajo muestras del exudado vaginal para frotis y cultivo por GC, suspensión por tricomonas, muestras endocervicales para papanicolau e IVPH y Clamydia por PCR.